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Atherosclerosis and estrogen replacement therapy

J M Sullivan1

  • 1Department of Medicine, University of Tennessee, Memphis.

International Journal of Fertility and Menopausal Studies
|January 1, 1994
PubMed
Summary
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Estrogen replacement therapy (ERT) may reduce cardiovascular disease risk in postmenopausal women, despite past concerns. Studies indicate a protective effect, particularly for those with existing coronary artery disease.

Area of Science:

  • Cardiology
  • Endocrinology
  • Women's Health

Background:

  • Cardiovascular morbidity and mortality significantly increase post-menopause.
  • Past concerns regarding estrogen replacement therapy (ERT) include adverse cardiovascular events in men and increased heart attack risk in older smoking women using oral contraceptives.
  • Conflicting evidence exists on ERT's cardiovascular safety in women.

Purpose of the Study:

  • To evaluate the effect of estrogen replacement therapy on cardiovascular events and mortality in postmenopausal women.
  • To assess the protective role of ERT against coronary artery disease and its impact on survival after coronary arteriography.

Main Methods:

  • Systematic review of case-control and cohort studies examining ERT and cardiovascular events.
  • Analysis of angiographic studies assessing coronary artery disease risk in relation to estrogen use.

Related Experiment Videos

  • Long-term survival study of postmenopausal women undergoing coronary arteriography, with and without ERT.

    • Main Results:

    • Multiple observational studies (case-control and cohort) suggest a protective effect of ERT on cardiovascular events.
    • Logistic regression analysis indicated estrogen use as a significant independent protective factor against coronary atherosclerosis.
    • ERT significantly reduced all-cause mortality in postmenopausal women with existing coronary artery disease, but not in those initially free of lesions.

    Conclusions:

    • Estrogen replacement therapy demonstrates a protective effect against cardiovascular events and atherosclerosis in postmenopausal women.
    • ERT is associated with reduced all-cause mortality in postmenopausal women with established coronary artery disease.
    • Further research may clarify optimal ERT strategies for cardiovascular risk reduction in this population.